Mehidine Hussein, Devaux Bertrand, Varlet Pascale, Abi Haidar Darine
Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France.
Université Paris Cité - Faculté de Médecine Paris Descartes, Paris, France.
Front Oncol. 2022 May 12;12:881331. doi: 10.3389/fonc.2022.881331. eCollection 2022.
Nowadays, surgical removal remains the standard method to treat brain tumors. During surgery, the neurosurgeon may encounter difficulties to delimitate tumor boundaries and the infiltrating areas as they have a similar visual appearance to adjacent healthy zones. These infiltrating residuals increase the tumor recurrence risk, which decreases the patient's post-operation survival time. To help neurosurgeons improve the surgical act by accurately delimitating healthy from cancerous areas, our team is developing an intraoperative multimodal imaging tool. It consists of a two-photon fluorescence fibered endomicroscope that is intended to provide a fast, real-time, and reliable diagnosis information. In parallel to the instrumental development, a large optical database is currently under construction in order to characterize healthy and tumor brain tissues with their specific optical signature using multimodal analysis of the endogenous fluorescence. Our previous works show that this multimodal analysis could provide a reliable discrimination response between different tissue types based on several optical indicators. Here, our goal is to show that the two-photon fibered endomicroscope is able to provide, based on the same approved indicators in the tissue database, the same reliable response that could be used intraoperatively. We compared the spectrally resolved and time-resolved fluorescence signal, generated by our two-photon bimodal endoscope from 46 fresh brain tissue samples, with a similar signal provided by a standard reference benchtop multiphoton microscope that has been validated for tissue diagnosis. The higher excitation efficiency and collection ability of an endogenous fluorescence signal were shown for the endoscope setup. Similar molecular ratios and fluorescence lifetime distributions were extracted from the two compared setups. Spectral discrimination ability of the bimodal endoscope was validated. As a preliminary step before tackling multimodality, the ability of the developed bimodal fibered endoscope to excite and to collect efficiently as well as to provide a fast exploitable high-quality signal that is reliable to discriminate different types of human brain tissues was validated.
如今，手术切除仍然是治疗脑肿瘤的标准方法。在手术过程中，神经外科医生可能难以界定肿瘤边界和浸润区域，因为它们与相邻的健康区域在视觉上相似。这些浸润性残余物会增加肿瘤复发风险，从而缩短患者的术后生存时间。为了帮助神经外科医生通过准确区分健康区域和癌性区域来改进手术操作，我们的团队正在开发一种术中多模态成像工具。它由一个双光子荧光光纤内窥镜组成，旨在提供快速、实时且可靠的诊断信息。在仪器开发的同时，一个大型光学数据库目前正在建设中，以便使用内源性荧光的多模态分析来表征健康和肿瘤脑组织的特定光学特征。我们之前的工作表明，这种多模态分析可以基于几个光学指标在不同组织类型之间提供可靠的鉴别反应。在这里，我们的目标是表明双光子光纤内窥镜能够基于组织数据库中相同的认可指标，提供可在术中使用的相同可靠反应。我们将我们的双光子双峰内窥镜从46个新鲜脑组织样本中产生的光谱分辨和时间分辨荧光信号，与已被验证用于组织诊断的标准参考台式多光子显微镜提供的类似信号进行了比较。内窥镜设置显示出对内源性荧光信号更高的激发效率和收集能力。从两个比较的设置中提取了相似的分子比率和荧光寿命分布。双峰内窥镜的光谱鉴别能力得到了验证。作为处理多模态之前的初步步骤，已验证了所开发的双峰光纤内窥镜有效激发和收集以及提供快速可利用的高质量信号以可靠区分不同类型人类脑组织的能力。
